Individual
ELISKA MIRVALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
389 S 900 E, SALT LAKE CITY, UT 84102-2310
(385) 282-2000
Mailing address
389 S 900 E, SALT LAKE CITY, UT 84102-2310
(385) 282-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
106756-1206
UT
Other
Enumeration date
08/03/2006
Last updated
02/25/2013
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